If being pregnant isn’t hard enough, suffering from hand and wrist problems that never previously bothered you just adds a whole new level of difficulty to this time in your life. At Dr Yong’s practice, every staff member is a mother. You are not alone. We understand how hard it gets. We’re with you, Mum.
Some of the common hand conditions in pregnancy arise due to fluid retention, hormonal changes, and weight gain. These include:
- Carpal tunnel syndrome
- de Quervain’s stenosing tenosynovitis/tenovaginitis
- Trigger finger or trigger thumb
- Pyogenic granuloma or lobular capillary haemangiomas
We wish to avoid any risk to your baby, and therefore recommend avoiding or deferring surgery, if at all possible. The good news is that most of these pregnancy and peripartum conditions tend to resolve over a few months after giving birth. However, if these do not resolve, consider seeking medical review as further treatment for these conditions may be required. In some cases, they require surgery which is generally a day procedure. Don’t hesitate to get in contact with us and organise a review with Dr Yong for a discussion to put your fears at rest.
Carpal tunnel syndrome in pregnancy is remarkably common, after lower back pain. This feels like pins-and-needles or numbness in the hand, particularly worse at night. Treatment options in pregnancy include seeing a hand therapist for splinting, and consideration of a local corticosteroid injection in severe cases.
de Quervain’s stenosing tenosynovitis is more common in the later stages of pregnancy and the postpartum period, when repetitive forceful motions of picking up a baby and changing nappies, can exacerbate the symptoms. This condition causes pain along the back of the thumb, and down the side of the wrist, a pain that is worsened when trying to give a thumbs up, use a scissors, or bringing the thumb across the palm to the base of the little finger. Treatment options in pregnancy include splinting for rest, and a local corticosteroid injection.
Trigger digits or trigger thumb are generally common conditions but fluid retention and swelling in pregnancy can potentiate the condition. This often feels like a clicking or catching with opening and closing the fingers that may be painful, particularly at the base of the digit. It is often worse in the morning. Treatment options include gliding exercises with your hand therapist, and a local corticosteroid injection.
Pyogenic granulomas are benign vascular tumours. The effect of oestrogen in pregnancy affects the factors that promote growth of these lesions. These are unsightly friable nodules that grow on the skin, and ulcerate or bleed easily. Often the drop in oestrogen levels after birth help this resolve. In the meantime, treatment with silver nitrate over a few weeks can help. Alternatively, if this does not resolve after birth, surgical excision is usually curative.